Survey: Missed work, cost cause older workers to forgo elective surgeries

Dive Brief:

  • Missed work and out-of-pocket costs are two of the most commonly cited concerns for older U.S. adults considering elective surgery, according to the results of a University of Michigan study published in JAMA Network Open Jan. 30.
  • The study of more than 2,000 adults ages 50 to 80 who considered having elective surgery in the past five years found that one-fifth were concerned about out-of-pocket costs. One-fifth were also concerned about the time needed to take off work to receive a procedure. Those with such concerns were less likely to undergo surgery, researchers found.
  • Researchers noted that the share of U.S. adults ages 60 and above who are employed doubled between 2000 and 2020, according to U.S. Census Bureau data. “Future studies should seek to clarify the implications of surgery for employment status and job productivity, in addition to identifying workplace policies that facilitate or limit time off for recovery,” the researchers wrote.

Dive Insight:

As with other areas of healthcare, cost is central to elective procedures, and the share of out-of-pocket costs paid by employees enrolled in employer-sponsored health plans has grown in recent years.

In 2022, the Employee Benefits Research Institute found that employees paid 19% of out-of-pocket costs in 2019, up from 17.4% in 2013. Additionally, EBRI said that the adoption of high-deductible health plans drove the increased spending and that out-of-pocket spending for outpatient services grew faster than for inpatient services. Overall employer healthcare costs are expected to climb 5.4% this year, according to a 2023 Mercer survey.

Older workers are not the only group to skip out on care over cost concerns. Many employees covered under employer-sponsored plans are underinsured, the Commonwealth Fund found in 2022. Forty-four percent of underinsured adults surveyed by the organization did not visit a doctor or clinic despite having a medical problem, while 43% did not partake in a recommended test, treatment or follow-up.

And if all that wasn’t enough, employers have also dealt with the potential costs of preventative care deferred by employees during the initial phase of the pandemic. That trend had already given rise to concerns that employees may have missed out on early detection of chronic diseases such as cancer, executives for the Business Group on Health said in 2022.

That older workers may also defer certain types of care could become an emerging issue for employers in the benefits space. Consulting firm Bain & Co. published a 2023 report finding that workers ages 55 and above could account for more than 1 out of 4 workers in countries such as the U.S. and Canada by 2031. Aside from healthcare strategy, employers also may have to make cultural adjustments to crack down on age discrimination at work, which can go undetected.